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UNDERGROUND STORAGE TANK SYSTEM <br />DESIGNATED OPERATOR FACILITY EMPLOYEE TRAINING RECORD <br />For use by Unatocs Member Agencies or where approved by yore Loco! Jurisdiction <br />Authority Cited: Title 23, Div 3, Ch. J6 California Code ofRegularions (CCR) <br />Xt <br />Facility Name: <br />-- - Qoua)d< M IN r ri. or <br />Facility Site Addrrsx: T_. <br />122L_ 1v:___�w <br />City' --L-.o cl 1, <br />Section 2715 of Tithe 23, California Code of Regulations, requires that Designated Underground Storage T <br />Provide training to facility employees who have responsibilities associated with the <br />underground rag mule Operators <br />storage tank (UST) systems This training must be ration and/or maintenance of <br />For facility employers hired after July 1, 2005, the initial training in 5. <br />by July 1, 2005' and every 12 months thereafter. <br />least one of the facility employees present duran g be provided within 30 days of the <br />is not limited to g operating hours must have c y date clhue. but the following UST items as specified in 23 CCR int training, This training must include, but <br />Sections 27 ] 5(fxl) and (2): <br />f5Operation of site UST system in a manner consistent with the facility's Best Management Practices; <br />The employee's role <br />Yf.The with regard to UST monitoring equipment as specified in the written US"l- Monitoring plan. <br />NttrneKs) <br />oe's role with regard to spills and overfills as specified in the written UST Response plan; <br />(� of contact peusort(s) for emergencies and monitoring equipment alarms, <br />23 CCR § 2715(f)(3) requires that a list of employees who have been trained by the Designated Underground Storage Tank <br />the local <br />ag o rnupon irted onsite, or eti=site at aread ily-available location if approved by the lout- ncY, and provided to <br />em locrtl s have upon request. (:ompletiun of this form will satisfy UST training record <br />empbyees have been tmined as r wired 6 23 CCR Sections 2715 1 keeping requUemeata The following <br />- - --- � y (�( )and (2): <br />7F�er ri�c rl <br />— fniniag Date Hire D <br />1.1_G <br />Wonn:nmed on reverse} <br />If how aft=lwy 1. 2005.—__--- <br />r Traiaar must be x mord" r)1-igmtpt I)ST t)perator ihr the fac0ay at the tmW ol'trammg. <br />UN -BFI - in <br />Trainer-Nam-e.'— <br />If <br />rainerName= <br />